Grief from a Death of a Loved One Is Part of Life

It is the biological process of the brain for healing and recovery from loss.

THE BASICS

Mourning is the biological process of the brain-body for healing and recovery from loss. Human attachment is deeply mapped in the limbic cortex, as the story of our relationships. It exists in the brain as the top-down cortical mappings of relationships. Mourning a death is the change from the deeply held story of a relationship to a new “play” where the loved one is dead and gone. (see the my Post “Mourning is the Key”).

Keep in mind that antidepressants should never be prescribed for grief. They inhibit mourning. They numb out feeling and harden the personality. I’ve treated many patients who had been on antidepressants for years and years after a death. It wasn’t until they got off of them that they were able to mourn and feel and come back to the world of the living. This is what it is to be human. Grief is not a brain problem, but part of the human condition.

The processes of mourning follow the basic brain principles for change in top-down cortical mappings. Here is an example of a change from in a simple top-down cortical mapping to another – the changing of a hand position for a chord on the guitar. When I learn the B7 hand position on the guitar I am actually laying down new neuromuscular mappings in the motor-sensory areas of my brain. This is accomplished by devoting my full attention to putting my fingers on the frets of the guitar. It hurts my hand; I can’t do it very readily. I can’t do it as a unit; It takes a long time to get my fingers right. Over time with repeated efforts and a few nights’ sleep, I get it. My brain mappings get established for top-down cortical functioning - I can play the chord as a whole, automatically, without thinking and incorporate it into playing music. Now, let’s say I had learned a scrunched up hand position and I want to change it. Then the following steps take place – I have to utilize my attention to disuse my old hand position; In order to have a new hand position for B7 I have to create a new neuromuscular map; I hold my hand on the fingerboard differently. Once again it hurts; I can’t do it well; after a while the new neuro-muscular maps establish themselves. And once formed, I can operate automatically and with ease. This is the paradigm for changing from one top-down cortical brain mapping to another.

Change in the limbic-cortical play of consciousness for relationships follows these same principles, but in this case it is not neuromuscular mappings, and the pain is not muscular. Since the ‘play’ is anchored in the limbic-cortex, the pain of change is in the realm of feeling. And the pain, by its nature, is powerful feelings. To change the top-down limbic cortical mappings from one play to accept a play of absence is called mourning. This is the process for healing from death, loss, trauma, and pain in psychotherapy.

One of my sons almost died in the World Trade Center. If he had, it would have taken me years to get back on my feet, at least partially. I would not have been able to practice psychiatry any more, because I have to be exquisitely responsive in feeling with my patients. This would not have been possible. And for sure, if I’d numbed myself out with antidepressants I couldn’t have been emotionally available. Life is difficult and healing from tragedies is very hard and has a life of its own.

Robert A. Berezin, MD is the author of “Psychotherapy of Character, the Play of Consciousness in the Theater of the Brain”

So we can't expect common sense and wisdom manifesting very easily from the APA. Too much mental activity disconnected from the rest of life. One of the side effects of over specialization is loosing knowledge of the forest.

As a result and as usual, the blinds are leading the blinds. That is the normal course in human history. And the results are often insults to the human condition.

Grief is normal and in the long term valuable to the extent in keeps our heart open, but I do think that modern cultures makes us much more fragile, vulnerable, fearful than it is either healthy or beneficial.

One interested area to investigate with this issue is Tibetan Buddhism which teaches compassion more than any culture than I know about and yet does not grieve to the extent western cultures do.

Dear Anonymous,
I would differ with you in the following respects. Mourning does more than keeping our hearts open. It allows us to recover our selves. This does not reflect an over fragility, but rather it is the work of healing from loss and pain. Although I value some aspects of Buddhism, I find that many of its teachings foster a distance and a removal from an engaged emotional life. Paradoxically, when this is an issue, it functions similarly to many psychiatric drugs, which I find problematic.

These comment boxes only allow for sound bites so often I find the differences of opinions are simply due to not being able to explain fully and with nuance one's thinking. Which is not possible here.

When we scratch our scabs all the time the wound never heals.
There is a time for support groups and a time to move on.

My view is that in our culture we have a tendency not to complete the healing process and come out whole at the other end. There is a tendency to access our feelings (which is a great and necessary first step) but to often wallow in them longer than it is healthy.

So far as I can tell most wisdom traditions that I am informed about tend to give us the room the grieve but not an infinite amount of room (But this without judgement). We do what we can but we are encouraged for our own good to move on.

Well, we see eye to eye on many points. For starters, this is all shorthand.
The whole point of mourning is to move on - To feel what has to be digested, in the respectful and emotional arms of another. Neither withdrawal and dismissing what has to be attended to, nor wallowing, serves anyone. And I, like you, don’t advocate either.

My darling father, my hero in life whom I loved dearly, took his life via Smith&Wesson when he was confronted with: death of his beloved spouse, my mother (after two years passed); inability to quit drinking/alcoholism, which appears to be genetic; doctor's report to him of his diabetes, high blood pressure, macular degeneration and among other maladies, impending, progressive dementia. He was raised by a divorced woman during the great depression, took advantage of the Civilian Conservation Corps to get work experience, was a WWII veteran, a Marine, former Los Angeles policeman (20 years) and independent hauler/trucker (another 20 years). I was already diagnosed major depressive when he died so it's been eight years and am just starting to feel "human" again. Your post was very helpful, Doctor Berezin. I don't "twitter" or "tweet," but will find some way to follow you. The DSM references resonated and hit home too. Thank you.

Husband lost his 8 and 10 year old to car accident , he had full custody and they lived in own home.. been two years. His mom also, she was driving car. Life has changed and so has he. I don't want to comment on here. However... Will it ever get better?

Husband lost his 8 and 10 year old to car accident , he had full custody and they lived in own home.. been two years. His mom also, she was driving car. Life has changed and so has he. I don't want to comment on here. However... Will it ever get better?